Dianne C. Berry

On the relationship between task performance and associated verbalizable knowledge

Three experiments explore the relationship between performance on a cognitive task and the explicit or reportable knowledge associated with that performance (assessed here by written post-task questionnaire). They examine how this relationship is affected by task experience, verbal instruction and concurrent verbalization. It is shown that practice significantly improves ability to control semi-complex computer-implemented systems but has no effect on the ability to answer related questions. In contrast, verbal instruction significantly improves ability to answer questions but has no effect on control performance. Verbal instruction combined with concurrent verbalization does lead to a significant improvement in control scores. Verbalization alone, however, has no effect on task performance or question answering.

Implicit learning: Below the subjective threshold

In this review, we consider three possible criteria by which knowledge might be regarded as implicit or inaccessible: It might be implicit only in the sense that it is difficult to articulate freely, or it might be implicit according to either an objective threshold or a subjective threshold. We evaluate evidence for these criteria in relation to artificial grammar learning, the control of complex systems, and sequence learning, respectively. We argue that the convincing evidence is not yet in, but construing the implicit nature of implicit learning in terms of a subjective threshold is most likely to prove fruitful for future research. Furthermore, the subjective threshold criterion may demarcate qualitatively different types of knowledge. We argue that (1) implicit, rather than explicit, knowledge is often relatively inflexible in transfer to different domains, (2) implicit, rather than explicit, learning occurs when attention is focused on specific items and not underlying rules, and (3) implicit learning and the resulting knowledge are often relatively robust.

Office noise and employee concentration: identifying causes of disruption and potential improvements

A field study assessed subjective reports of distraction from various office sounds among 88 employees at two sites. In addition, the study examined the amount of exposure the workers had to the noise in order to determine any evidence for habituation. Finally, respondents were asked how they would improve their environment (with respect to noise), and to rate examples of improvements with regards to their job satisfaction and performance. Out of the sample, 99% reported that their concentration was impaired by various components of office noise, especially telephones left ringing at vacant desks and people talking in the background. No evidence for habituation to these sounds was found. These results are interpreted in the light of previous research regarding the effects of noise in offices and the ‘irrelevant sound effect’.

Provision of information about drug side-effects to patients

To make informed decisions about taking medicinal drugs, people need accurate information about side-effects. A European Union guideline now recommends use of qualitative descriptions for five bands of risk, ranging from very rare (affecting <0.01% of the population), to very common (>10%). We did four studies of more than 750 people, whom we asked to estimate the probability of having a side-effect on the basis of qualitative and quantitative descriptions. Our results showed that qualitative descriptions led to gross overestimation of risk. Until further work is done on how patients taking the drugs interpret these terms, the terms should not be used in drug information leaflets.

Comparison of two methods of presenting risk information to patients about the side effects of medicines

Objective: To determine whether the use of verbal descriptors suggested by the European Union (EU) such as “common” (1–10% frequency) and “rare” (0.01–0.1%) effectively conveys the level of risk of side effects to people taking a medicine. Design: Randomised controlled study with unconcealed allocation. Participants: 120 adults taking simvastatin or atorvastatin after cardiac surgery or myocardial infarction. Setting: Cardiac rehabilitation clinics at two hospitals in Leeds, UK. Intervention: A written statement about one of the side effects of the medicine (either constipation or pancreatitis). Within each side effect condition half the patients were given the information in verbal form and half in numerical form (for constipation, “common” or 2.5%; for pancreatitis, “rare” or 0.04%). Main outcome measure: The estimated likelihood of the side effect occurring. Other outcome measures related to the perceived severity of the side effect, its risk to health, and its effect on decisions about whether to take the medicine. Results: The mean likelihood estimate given for the constipation side effect was 34.2% in the verbal group and 8.1% in the numerical group; for pancreatitis it was 18% in the verbal group and 2.1% in the numerical group. The verbal descriptors were associated with more negative perceptions of the medicine than their equivalent numerical descriptors. Conclusions: Patients want and need understandable information about medicines and their risks and benefits. This is essential if they are to become partners in medicine taking. The use of verbal descriptors to improve the level of information about side effect risk leads to overestimation of the level of harm and may lead patients to make inappropriate decisions about whether or not they take the medicine.

What do patients want to know about their medicines, and what do doctors want to tell them?: A comparative study

Abstract A two phase study is reported. In the first phase, we asked a number of doctors to rate a list of information categories (identified by Berry, Gillie and Banbury 1995) in terms of how important they felt it was for the items to be included in an explanation to a patient about a drug prescription. In the second phase, we presented a large sample of people with a scenario about visiting their doctor and being prescribed medication, together with an explanation about the prescription which was said to be provided by the doctor. Four different explanations were compared, which were either based on what people in our earlier study wanted to know about drug prescriptions or on what the doctors thought it was important lo tell them. We also manipulated whether or not the explanations conveyed negative information (e.g. about the possible side effects of the medication). The results showed that people ‘preferred’ the explanations based on what the participants in the earlier study wanted to know about th...

Patients understanding of risk associated with medication use: Impact of European Commission guidelines and other risk scales.

Patients want and need comprehensive and accurate information about their medicines so that they can participate in decisions about their healthcare. In particular, they require information about the likely risks and benefits that are associated with the different treatment options. However, to provide this information in a form that people can readily understand and use is a considerable challenge to healthcare professionals. One recent attempt to standardise the language of risk has been to produce sets of verbal descriptors that correspond to specific probability ranges, such as those outlined in the European Commission (EC) Pharmaceutical Committee guidelines in 1998 for describing the incidence of adverse effects.This paper provides an overview of a number of studies involving members of the general public, patients, and hospital doctors, that evaluated the utility of the EC guideline descriptors (very common, common, uncommon, rare, very rare). In all studies it was found that people significantly over-estimated the likelihood of adverse effects occurring, given specific verbal descriptors. This in turn resulted in significantly higher ratings of their perceived risks to health and significantly lower ratings of their likelihood of taking the medicine. Such problems of interpretation are not restricted to the EC guideline descriptors. Similar levels of misinterpretation have also been demonstrated with two other recently advocated risk scales (Calman’s verbal descriptor scale and Barclay, Costigan and Davies’ lottery scale).In conclusion, the challenge for risk communicators and for future research will be to produce a language of risk that is sufficiently flexible to take into account different perspectives, as well as changing circumstances and contexts of illness and its treatments. In the meantime, we urge the EC and other legislative bodies to stop recommending the use of specific verbal labels or phrases until there is a stronger evidence base to support their use.

Learning a procedural task: effectiveness of multimedia presentations

Three experiments investigated the effectiveness of presenting procedural information through different media and their combinations. Experiment 1 examined the effectiveness of text, line drawings, text and line drawings, video. and video stills for learning a first aid task. The results showed an advantage of text and line drawings and of the video presentation over the other three conditions for both bandaging performance and answering questions about the task. Experiment 2 showed that the beneficial effect of the combination of text and pictures could not be accounted for simply in terms of a dual coding explanation. Rather, the effectiveness of the media and their combinations was influenced by the extent to which they conveyed action information. Finally, Experiment 3 showed no evidence of a contiguity effect: text and pictures were as effective when presented together on the same screen as when they were presented separately. Copyright

The role of action in implicit learning

This study looks at whether or not a crucial role is played by the learners own actions in tasks known to give rise to implicit learning. Experiment 1 shows that experience of watching another person controlling Berry and Broadbents (1984) sugar production and person interaction tasks has no effect on subsequent control performance. Experiment 2 demonstrates that this lack of effect of observing is limited to tasks where the underlying relationship is not obvious or salient. In Experiment 3 the length of the observation period is doubled, but this still has no beneficial effect on subsequent control performance. Experiments 4 and 5 address the question of what it is about controlling itself that leads to learning. They examine whether it is the decision-making component or the physical interaction component that is important. The results emphasize the importance of the role of action in learning to control these tasks. They show that decision must be tied to action in order to be maximally effective, at least in the early stages of learning.

Habituation and dishabituation to speech and office noise

The authors examined whether background noise can be habituated to in the laboratory by using memory for prose tasks in 3 experiments. Experiment 1 showed that background speech can be habituated to after 20 min exposure and that meaning and repetition had no effect on the degree of habituation seen. Experiment 2 showed that office noise without speech can also be habituated to. Finally, Experiment 3 showed that a 5-min period of quiet, but not a change in voice, was sufficient to partially restore the disruptive effects of the background noise previously habituated to. These results are interpreted in light of current theories regarding the effects of background noise and habituation; practical implications for office planning are discussed.